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      Point Prevalence of Pseudoexfoliation Syndrome in Patients Scheduled for Cataract Surgery in Eye Camps in Yemen

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          Abstract

          Purpose:

          To study the point prevalence of pseudoexfoliation syndrome (PXS) among Yemeni patients in different governorates with age-related cataract scheduled for surgery.

          Settings:

          Eye camps organized by the Nibras Health Society to perform cataract surgeries during the years 2002-2006. All patients aged 40 years and above were included in the study.

          Materials and Methods:

          A total of 2535 eyes of 2535 patients from 13 governorates, scheduled for cataract surgery in eye camps, were included. All eyes underwent complete eye examination before the surgery and were evaluated for the signs of pseudoexfoliation material in the pupil, iris and lens capsule on dilated slit lamp examination.

          Results:

          The study found 495 of the 2535 eyes (19.53%) with PXS with males more commonly affected than females (55.2 and 44.8%, respectively). The mean age of patients with PXS was 66.2 years while it was 64.6 years in non-PXS patients. The prevalence of pseudoexfoliation syndrome increased with age (10.1% in the age group of 41-50 years that increased to 28.8% in the age group of more than 81 years old). The rate of PXS detection in camps in 13 governorates ranged from 13.33 to 24.22% with an overall rate of 19.53%. The lowest rate was noticed in Sana'a and the highest in Al-Dhale governorate.

          Conclusion:

          This pilot study confirms that PXS was common in patients undergoing cataract surgery in Yemen with an increased detection rate with age. This study also highlights the prevalence of an ocular disease that is associated with systemic and ocular complications; however, further studies based on population studies are needed.

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          Most cited references21

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          Clinical signs of the pseudoexfoliation syndrome.

          Pseudoexfoliation syndrome (PXS) is a common cause of glaucoma throughout the world. It is most commonly diagnosed after the observation of pseudoexfoliation material (PXM) on the anterior lens surface. However, there are numerous clinical signs of PXS that should alert the examiner to search carefully for PXM on the anterior lens surface. These include pupillary ruff defects, iris sphincter transillumination, a characteristic whorl-like pattern of particulate pigment deposition on the iris sphincter, particulate pigment deposition on the peripheral iris and trabecular meshwork, and exfoliation material on the zonules and ciliary body. Accuracy of diagnosis is important for purposes of treatment, prognosis, and basic research in he mechanisms of glaucoma, particularly tissue culture.
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            Prevalence and risk factors of lens opacities in the elderly in Finland. A population-based study.

            The distribution and prevalence of lens opacities and visual impairment caused by cataract were studied in an epidemiologic cross-sectional population study of inhabitants 70 years of age or older in three communities in Oulu County, Finland. Of the 560 eligible subjects, 500 (89.3%) were examined. The best-corrected visual acuity for distance in both eyes was determined. The diagnosis of lens opacities was based on clinical biomicroscopy. The findings were compared with standardized photographs of the Lens Opacities Classification System II. One hundred sixty-five (33.0%) persons in the study population had a clear lens in both eyes. Cataract, aphakia, or pseudophakia was recorded in one or both of the eyes in 64.4% (322 persons) of the participants. The prevalence increased with age from 44.6% of persons (n = 88) in the 70- to 74-year-old age group to 97.6% of persons (n = 41) in the 85- to 89-year-old age group. A total of 56.4% of persons had cataract, aphakia, or pseudophakia in both eyes. Nuclear, cortical, and posterior subcapsular opacities were detected in 38.5%, 37.6%, and 27.7% of the participants, respectively. Exfoliation was present in one or both eyes in 22.1% of the participants. There was no difference in the prevalence of cataract between the sexes when age was considered. Visual impairment to 20/50 or worse was at least partly due to cataract in 23.8% of the right eyes and 22.4% of the left eyes. Significant risk factors for cataract were age and the presence of exfoliation in men and age, occupational exposure to sunlight, and current cigarette smoking in women. Almost two thirds of the population 70 years of age or older had lens opacities, and in 23.1% of the eyes visual impairment to 20/50 or worse was at least partly due to cataract. Including the patients who had undergone surgery, 30.3% of all the eyes of persons 70 years of age or older can be considered for cataract surgery.
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              Exfoliation syndrome in various ethnic populations.

              H Forsius (1987)
              This introductory lecture to the epidemiological session in the Workshop on the Exfoliation Syndrome (ES) gathers together figures for the prevalence of ES around the world. Prevalence figures from published reports are shown in the text separately for each country. Four ways of comparing the prevalences are used. 1) Prevalences in people over 60 years of age, 2) Percentages of glaucoma in persons with ES, 3) Percentages of ES in patients with glaucoma or ocular hypertension, with separate statistics for the proportion of capsular glaucoma in patients treated with laser trabeculoplasty (LTP), 4) Prevalence of ES in patients with cataract. The major differences in prevalence can partly be explained by the different techniques used in the investigations. Very few authors have studied people in different countries, which is the best way of obtaining comparable results. The author has personally studied Finns, Lapps, Eskimos in Greenland, Canada and Alaska, Icelanders, populations in Tunis, India and Peru and four populations in the USSR by the same technique. The prevalences vary from 0% in Eskimos to 21% in Finns over 60 years of age, and are at the same high level in Lapps, Finns, Russians in Novosibirsk and Icelanders, but significantly lower in all the others. The results support the opinion that ES is not uniformly distributed in all countries, and this is confirmed by many reports from different countries in this workshop.
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                Author and article information

                Journal
                Middle East Afr J Ophthalmol
                MEAJO
                Middle East African Journal of Ophthalmology
                Medknow Publications (India )
                0974-9233
                0975-1599
                Jan-Mar 2010
                : 17
                : 1
                : 74-77
                Affiliations
                Department of Ophthalmology, Faculty of Medicine and Health Sciences, Sana'a University, Yemen
                Author notes
                Corresponding Author: Dr. Mahfouth A Bamashmus, Faculty of Medicine and Health Sciences, Sana'a University, P. O. Box 19576, Sana'a, Yemen. E-mail: bamashmus@ 123456y.net.ye
                Article
                MEAJO-17-74
                10.4103/0974-9233.61221
                2880378
                20543941
                f7cb55aa-c157-4cd8-a0ef-acb5918e2f63
                © Middle East African Journal of Ophthalmology

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Categories
                Original Article

                Ophthalmology & Optometry
                cataract,eye camps,yemen,prevalence,pseudoexfoliation syndrome
                Ophthalmology & Optometry
                cataract, eye camps, yemen, prevalence, pseudoexfoliation syndrome

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